> Locally Advanced or Inflammatory Breast Cancer (Stage III)
Locally advanced breast cancer (stage III) has spread beyond the breast (to the chest wall or the skin of the breast) or to the lymph nodes in the armpit (axillary nodes), but not to other organs. Cancer may be present in the skin around the breast or there may be cancer in multiple nearby lymph nodes. (For more on breast cancer stages, see the Diagnosis section).
Locally advanced breast cancer is treated with a combination of surgery, radiation and chemotherapy. Depending on certain tumor characteristics, treatment may also include hormone therapy and/or targeted therapy. Treatment usually begins with neoadjuvant therapy (prior to surgery) with an anthracycline- and/or taxane-based chemotherapy [63]. With treatment, there is a 50 to 60 percent chance of surviving five years after diagnosis [74].
Inflammatory Breast Cancer
Inflammatory breast cancer is a rare but aggressive type of locally advanced breast cancer. It is called inflammatory breast cancer because its main symptoms are swelling and redness of the breast, which look like inflammation. Because of these symptoms and the frequent lack of a breast lump, inflammatory breast cancer can first be mistaken for an infection. Inflammatory breast cancer is often diagnosed after these symptoms do not improve with a course of antibiotics.
The first treatment for inflammatory breast cancer is neoadjuvant therapy (prior to surgery), usually with an anthracycline- and/or taxane-based chemotherapy [63]. If the tumor is HER2/neu-positive, neoadjuvant trastuzumab may also be given, but not at the same time as an anthracycline-based chemotherapy [63]. With inflammatory breast cancer, a mastectomy is recommended, followed by a combination of radiation therapy, chemotherapy, hormone therapy and/or targeted therapy. A combination of treatments that includes chemotherapy offers the best chance of survival with inflammatory breast cancer [74]. With proper treatment, up to 50 percent of those with inflammatory breast cancer will live for five years after diagnosis and about 35 percent will be cancer-free 10 years after diagnosis [74-77].
Treatment Guidelines
Although the exact treatment for locally advanced breast cancer varies from person to person, several organizations have guidelines to help ensure quality care. These guidelines are based on the latest research, and some are available online. The American Society of Clinical Oncology (ASCO) and National Comprehensive Care Network (NCCN) are two respected organizations that regularly update and post their guidelines online. The National Cancer Institute (NCI) also has overviews of treatment options.
Playing an Active Role
Many people choose to play an active role in making treatment decisions. By understanding your breast cancer and your treatment options and their possible risks and benefits, you and your health care provider can choose treatments that fit your values and lifestyle.
Updated 01/22/10
